Your Guide to Your Trabecular Bone

Trabecular bone is one of the two types of bones. It makes up a small portion of your total skeleton but is a better indicator of certain bone diseases than cortical bone, the other type of bone.

Your bone health is crucial to your quality of life. After the age of 50, half of women and a quarter of men will experience a bone fracture, or break, caused by osteoporosis. The bones most susceptible to this disease are the hips, knees and back. By the end of this article, you will learn what trabecular bone is, how diseases affect this bone and how to keep this bone healthy, particularly as you age. It is of critical importance to protect your bone health before your condition deteriorates to minimize your risk of bone diseases or breaks.  

What Is Trabecular Bone?

The body is comprised of two types of bone - the cortical and trabecular. The trabecular bone makes up around 20% of your skeleton and is sometimes referred to as the cancellous bone. It is a network of rods and plates patterned in such a way that maximal strength is provided. This design allows for a large availability for the surface area of the bone to transport minerals. This type of bone is the most responsible for overall bone strength. The cortical bone is the shell that houses this bone structure.

Bone Mineral Density

Trabecular bone mineral density is a much greater predictor of fracture risk and fragility of the vertebra than cortical bone mineral density. Poor cortical bone mineral density is often indicative of fragility in the leg bones such as the tibia or femur.

Two factors affect apparent bone density. The first is apparent voids in the trabecular bone. The second is the levels of minerals present in the bone. Doctors may recommend a DXA scan to measure bone mineral density increases in response to osteoporosis treatment medications. The bone mineral density (BMD) of your lumbar spine is expected to increase much more significantly than the BMD of your hips and knees.

How Disease Affects Trabecular Bone

Diseases such as osteoporosis or bone cancer affect the trabecular bone much more rapidly than the denser cortical bones. Bone loss can cause the rods and plates to thin which increases your risk of broken bones. The creation of fragile, porous bone is also caused by bone disease. This also increases your risk of suffering from a bone fracture. Different types of diseases affect the trabecular bone differently.


Osteoporosis is the most common form of bone disease. There are several types of osteoporosis, but they are all characterized by bone structure deterioration, low bone density and mass, weak, brittle or fragile bones and an increased risk of bone fracture. Primary osteoporosis most commonly affects the elderly but may be idiopathic and affect adolescents or children.

This occurrence is a rarity. Idiopathy refers to a spontaneously occurring condition or disease with unknown cause. In this way, age-related osteoporosis is idiopathic as well. Scientists know menopause is a significant risk factor for the disease but not every woman who reaches menopause suffers from it.

Juvenile Osteoporosis

Juvenile osteoporosis can range in severity from mild to severe. This condition affects children and adolescents and usually develops between the ages of eight to 14. Mild cases of this disease may cause only the collapse of one or two spinal vertebrae while severe cases can affect nearly the entire spine.

Possible causes of this form of disease include anorexia nervosa or corticosteroid use. Five to 10 years of spinal fractures can lead to a loss in height of up to six inches. This condition affects both males and females equally.

Secondary Osteoporosis

Secondary osteoporosis of the trabecular bone may occur due to certain medications, toxic agents or other medical conditions. They experience bone loss at a much more accelerated rate than others in their same demographic of sex, race and age. A sixth of women in America suffer from osteoporosis caused by secondary or outside sources and most men suffer from this same disease.

How to Keep Trabecular Bone Healthy

The health of your trabecular bone is affected by both nature and nurture. Genes mostly determine the size and shape of your skeleton and birth defects may be caused by signaling errors from these genes. Astronauts returning from space are a prime example of how your environment affects bone health.  Gravity constantly applies your bones with a mechanical load which allows your skeletal system to maintain adequate density levels. Lack of regular stress on the bones results in bone loss. Individuals with mobility issues such as those who are wheelchair bound or bed bound due to morbid obesity are at particularly high risk for broken bones. Here is how to keep your bones healthy as you age. 

Eat Healthy Foods

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Key nutrients for your bones include vitamins C, D and K and calcium. If you are not vegan, you can get large supplies of high-quality calcium through dairy products. These are often fortified with vitamin D because vitamin D is important for your body to transport calcium from your intestines through your blood to your bones.

Talk to your doctor if you struggle to get adequate vitamins and minerals from your diet. Nondairy foods high in vitamin C include green and red bell peppers, Brussel sprouts, strawberries and citrus fruits such as pineapples and oranges. Foods high in vitamin K and calcium include purple cabbage, broccoli, spinach, collard greens and kale. You can also get calcium from protein such as tofu, white beans, sardines, tuna, mackerel and salmon.

Abstain From Nicotine

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Nicotine is a chemical found in products such as cigarettes, cigarillos, cigars, chewing tobacco and e-liquid for e-cigarettes. Nicotine has been shown to decrease bone mass density. The longer you smoke and the more cigarettes you smoke, the greater your risk of a bone fracture. Menopause is a significant risk factor for bone loss and fractures and women who smoke are far more likely to produce inadequate levels of estrogen and go through menopause early.

Soda and Alcohol in Moderation

Alcohol impairs your central nervous system and leads to falls which increases your risk of bone fractures. It also reduces your BMD. Women should consume no more than one alcoholic beverage daily and men should consume at most two alcoholic beverages daily but no more than 10 weekly. Replace soda, which lowers BMD, with calcium-fortified fruit juice or milk.

Soak in the Rays

Sunbathing is a great way to get vitamin D if you wear sunscreen to protect your skin from the sun's harmful UV rays. If you have fair skin or live near the equator, you may need as little as five to 30 minutes of sun exposure a couple times weekly. If you have a darker complexion or live far from the equator, you may need to consume foods such as fatty fish, fortified juice, cereal and milk, cheese and egg yolks.

Review Your Medications

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Certain medications can impact your bone health negatively. Corticosteroids are anti-inflammatory medications to treat the symptoms of arthritis. However, they slow the calcium absorption rate and speed the rate calcium is excreted by the kidneys via urination. Take corticosteroids for the shortest amount of time possible at the lowest possible dose to achieve the reduction of pain.

If you need high doses of corticosteroids or this is a long-term pain management solution for you, talk to your doctor to treat or prevent osteoporosis. Ask if you can have the corticosteroid injected into your joint or joints directly to minimize bone damage that you would experience if you took oral corticosteroids.

Consider Treatment Options

If you have been diagnosed with bone disease such as osteopenia or osteoporosis or cancer which may spread to your bones, talk to your doctor about supplements you can take to prevent or treat bone disease. This class of drugs, known as bisphosphonates, promotes the growth of new bone while slowing the breakdown of old bone, attacking your bone loss from two sides at once. Your doctor can advise you on the best medication to take based on any allergies to medications you have or side effects you wish to avoid.


Trabecular bone makes up only around 20% of your skeleton, encased in a husk of cortical bone. It is a great predictor for bone-related diseases such as osteoporosis. Both hereditary and environmental factors affect your bone density and health. Scientists do not know the exact cause of any type of osteoporosis, but there are things to do to mitigate your risk of bone disease and protect the overall health and strength of the bone.

Get adequate calcium and vitamins C, D and K through a healthy diet and talk to your doctor about taking supplements if necessary. Supplement your vitamin D intake with sun exposure, drink alcohol and soda in moderation and abstain from cigarettes. Review all medications you take with your doctor if you worry about your risk of osteoporosis.

Medications such as corticosteroids should be taken as direct injections rather than orally if used to manage inflammatory pain caused by arthritis. Take the lowest dosage possible for the shortest amount of time possible. If you need to take steroids regularly, ask your doctor about taking medications to mitigate your risk of developing osteoporosis. 

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